Rehabilitation of young immigrants in primary care. A comparison between two treatment models

Abstract

Objective: To evaluate the effect on well-being and sickness certification of interviews and three dialogue sessions concerning ideas about pain in young immigrants suffering from longstanding, benign pain.

Design: A randomized clinical four-week trial between two treatment groups.

Setting: A primary health care centre, Stockholm, Sweden.

Subjects: 92 persons, 25-45 years of age, on sick leave > 6 weeks.

Measures: Physical and psychiatric examinations and self-ratings of work ability and pain anxiety were made before and after the programme. Sick leave data were studied at three and eight-month follow-ups.

Results: 45 immigrants, mean age 38 years, mean sick leave 13 months, completed the programme. There were no significant differences in general or diagnostic data between the treatment groups. All had pain. Three-quarters reported pain anxiety. Nearly half had depressive disorders. Only ten persons had self-rated ability for part-time work. After the programme, there were significant differences in favour of the experimental group in number of participants with pain anxiety (p = 0.01), with diagnosed depression (p < 0.05), with self-rated work ability (p = 0.05), and in the number of participants who had returned to work at the eight-month follow-up (p < 0.05).

Conclusions: This study indicates that, for young immigrants suffering from long-standing benign pain, a structured dialogue with focus on concepts of pain may reduce pain anxiety and depressive mood, improve self-rated work ability, and increase the prospects of successful rehabilitation back to work.